Is there a treatment for the Turker blues? A fully remote nationwide randomized controlled trial of a digital intervention for depression in adult online workers

J Consult Clin Psychol. 2025 Nov;93(11):719-734. doi: 10.1037/ccp0000982.

ABSTRACT

OBJECTIVE: We conducted a nationwide, fully remote two-arm randomized controlled trial to test the efficacy of a self-guided internet-based behavioral activation (BA) intervention for depression in online workers. The intervention was a 4-week program designed as part of the Common Element Toolbox (COMET).

METHOD: Eight hundred five online workers who screened for depression were randomized to COMET-BA or a wait-list control. Self-report measures of depression, anxiety, subjective well-being, BA, psychosocial function, and emotion regulation were collected weekly for 4 weeks, 1-week postintervention, and then at a 1-month follow-up. The design and analytic plan were preregistered.

RESULTS: There was a significant Time × Treatment interaction during the intervention phase of the study. Those in COMET-BA improved significantly more than those in the wait-list control, with small-medium differences in depression (standardized mean difference = -0.32; 95% CI [-0.47, -0.17]). All but two outcomes demonstrated significant improvements, which were maintained during the 1-month follow-up period.

CONCLUSION: BA may be effectively delivered as a self-guided online intervention for depression in online workers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:41182705 | DOI:10.1037/ccp0000982